Journal article
Reliability of single office blood pressure measurements.
- Burkard T Hypertension Clinic, ESH Hypertension Centre of Excellence, Medical Outpatient Department, University Hospital Basel, Basel, Switzerland.
- Mayr M Hypertension Clinic, ESH Hypertension Centre of Excellence, Medical Outpatient Department, University Hospital Basel, Basel, Switzerland.
- Winterhalder C Department of Internal Medicine, University Hospital Basel, Basel, Switzerland.
- Leonardi L Department of Internal Medicine, University Hospital Basel, Basel, Switzerland.
- Eckstein J Department of Internal Medicine, University Hospital Basel, Basel, Switzerland.
- Vischer AS Hypertension Clinic, ESH Hypertension Centre of Excellence, Medical Outpatient Department, University Hospital Basel, Basel, Switzerland.
- 2018-03-14
Published in:
- Heart (British Cardiac Society). - 2018
cardiac risk factors and prevention
hypertension
Adult
Blood Pressure Monitoring, Ambulatory
Cross-Sectional Studies
Diastole
Female
Humans
Male
Masked Hypertension
Middle Aged
Switzerland
Systole
White Coat Hypertension
English
OBJECTIVES
Standard operating procedures for office blood pressure measurement (OBPM) vary greatly between guidelines and studies. We aimed to compare the difference between a single OBPM and the mean of the three following measurements. Further, we studied how many patients with possible hypertension may be missed due to short-term masked hypertension (STMH) and how many might be overdiagnosed due to short-term white coat hypertension (STWCH).
DESIGN AND SETTING
In this cross-sectional, single-centre trial, 1000 adult subjects were enrolled. After 5 min of rest, four sequential standard OBPMs were performed at 2 min intervals in a quiet room in sitting position. We compared the first (fBPM) to the mean of the second to fourth measurement (mBPM). STMH was defined as fBPM <140 mm Hg systolic and <90 mm Hg diastolic and mBPM systolic ≥140 mm Hg or diastolic ≥90 mm Hg. STWCH was defined as fBPM systolic ≥140 mm Hg or diastolic ≥90 mm Hg and mBPM <140 mm Hg systolic and <90 mm Hg diastolic.
RESULTS
Complete measurements were available in 802 subjects. Between fBPM and mBPM, 662 (82.5%), 441 (55%) and 208 (25.9%) subjects showed a difference in systolic and 531 (66.2%), 247 (30.8%) and 51 (6.4%) in diastolic blood pressure (BP) values of >2 mm Hg, >5 mm Hg and >10 mm Hg, respectively. In 3.4% of initially normotensives STMH and in 34.3% of initially hypertensives, STWCH was apparent.
CONCLUSIONS
There are significant differences between a single OBPM and the mean of consecutive BP measurements. Our study provides evidence that a single OBPM should not be the preferred method and should be discouraged in future guidelines.
TRIAL REGISTRATION NUMBER
NCT02552030;Results.
Standard operating procedures for office blood pressure measurement (OBPM) vary greatly between guidelines and studies. We aimed to compare the difference between a single OBPM and the mean of the three following measurements. Further, we studied how many patients with possible hypertension may be missed due to short-term masked hypertension (STMH) and how many might be overdiagnosed due to short-term white coat hypertension (STWCH).
DESIGN AND SETTING
In this cross-sectional, single-centre trial, 1000 adult subjects were enrolled. After 5 min of rest, four sequential standard OBPMs were performed at 2 min intervals in a quiet room in sitting position. We compared the first (fBPM) to the mean of the second to fourth measurement (mBPM). STMH was defined as fBPM <140 mm Hg systolic and <90 mm Hg diastolic and mBPM systolic ≥140 mm Hg or diastolic ≥90 mm Hg. STWCH was defined as fBPM systolic ≥140 mm Hg or diastolic ≥90 mm Hg and mBPM <140 mm Hg systolic and <90 mm Hg diastolic.
RESULTS
Complete measurements were available in 802 subjects. Between fBPM and mBPM, 662 (82.5%), 441 (55%) and 208 (25.9%) subjects showed a difference in systolic and 531 (66.2%), 247 (30.8%) and 51 (6.4%) in diastolic blood pressure (BP) values of >2 mm Hg, >5 mm Hg and >10 mm Hg, respectively. In 3.4% of initially normotensives STMH and in 34.3% of initially hypertensives, STWCH was apparent.
CONCLUSIONS
There are significant differences between a single OBPM and the mean of consecutive BP measurements. Our study provides evidence that a single OBPM should not be the preferred method and should be discouraged in future guidelines.
TRIAL REGISTRATION NUMBER
NCT02552030;Results.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1136/heartjnl-2017-312523
- PMID 29530989
- Persistent URL
- https://sonar.ch/global/documents/202371
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